Naseer Ahmed
University OF Verona Medical School, Italy
Title: Electrocardiographic Alterations after Aortic Valve Replacement
Biography
Biography: Naseer Ahmed
Abstract
Background:
Aortic Valve Replacement (AVR) is first line therapy of aortic stenosis (AoS). As the aortic valve is in close proximity to the atrioventricular node and His bundle manipulation during AVR may cause atrioventricular conduction abnormalities. The objective of this study was to examine the time course of alterations in the surface electrocardiogram after surgical aortic valve replacement.
Methods:
The study population consisted of 127 consecutive patients (mean age 66±12 years, 84 male), with AoS underwent AVR. Standard 12-lead ECGs were obtained at baseline (within 6 months prior to procedure) named as Group I, early (within 3 days) considered as Group II and late (4th post-operative day until 6 months) named Group III after valvular heart surgery.
Results
In 127 pre-operative ECGs, SR, Atrial Fibrillation (AF) and Atrial Flutter (AFL) was present in respectively 108(79%), 18(20%) and 1(1%) patients. Atrio-Ventricular (AV) block (first degree) (N=15, 13%), Left Bundle Branch Block (LBBB) (N=11, 9%) Right Bundle Branch Block (RBBB) (N=10, 8%) and Left Anterior Fascicular Block (LAFB) (N=8, 6%) were present in Group I. In Group III, AVB (N=13, 24%) (P=0.034), LBBB (N=10, 13%) (P=0.705), RBBB (N=12, 17%) (P=0.025), and LAFB (N=8, 12%) (P=0.414) were detected. Frequency of AF/AFL increased in Group III (N=23, 30%) (P=0.012) versus Group I (N=18, 14%). (p= 0.012).
Conclusion:
The electrocardiographic changes during aortic valve replacement surgery increases significantly incidence of conduction abnormalities including AV block (grade 1) and RBBB. Incidence of late post-operative AF is also significant as compared to pre-procedural AF